【摘要】 目的探讨维生素D₃辅助治疗儿童咳嗽变异性哮喘的疗效及其有关机制。方法选取2018年1月至2019年12月沈阳医学院附属中心医院儿科收治的80例咳嗽变异性哮喘患儿作为研究对象,随机分为观察组与对照组,各40例。所有患儿给予布地奈德混悬液雾化吸入+孟鲁司特钠咀嚼片治疗,观察组在此基础上加用维生素D₃（800 IU/d）辅助治疗,疗程为3个月。比较两组治疗前后咳嗽症状评分、血清免疫球蛋白、外周血T细胞亚群及呼出气一氧化氮（FeNO）水平变化情况。结果观察组治疗后日间和夜间咳嗽评分显著低于对照组（P<0.05）。治疗后观察组IgG、IgA及IgM水平明显高于对照组（P<0.05）。与对照组比较,观察组CD4⁺、CD4⁺/CD8⁺显著降低,而CD8⁺显著升高,差异有统计学意义（P<0.05）。治疗后观察组FeNO显著低于对照组（P<0.05）。结论补充维生素D₃（800IU/d）辅助糖皮质激素治疗儿童咳嗽变异性哮喘,可以改善机体免疫紊乱,减轻气道炎症,进而减轻气道高反应,改善患儿咳嗽症状及预后。更多还原

【Abstract】 Objective To investigate the effect and related mechanism of vitamin D₃ in the treatment of cough variant asthma in children. Methods A total of 80 child patients admitted to Central Hospital Affiliated to Shenyang Medical College who were diagnosed with cough variant asthma were randomly divided into an observation group and a control group, with 40 cases in each group. All the child patients were treated with budesonide suspension atomization inhalation plus montelukast sodium chewable tablets. The observation group was treated with vitamin D₃（800 IU/d） adjuvant therapy plus budesonide suspension atomization inhalation plus montelukast sodium chewable tablets. The course of treatment was 3 months. The cough symptom scores, serum immunoglobulin, peripheral blood T cell subsets and fractional exhaled nitric oxide（FeNO） levels of the 2 groups were compared before and after treatment. Results The scores of daytime and nighttime cough in the observation group were significantly lower than those in the control group and before treatment（P<0.05）. After treatment, the levels of IgG, IgA and IgM in the observation group were significantly higher than those in the control group（P<0.05）. Compared with the control group, the observation group’s CD4⁺, CD4⁺/CD8⁺ decreased significantly, while CD8⁺ increased significantly, and the difference was statistically significant（P<0.05）. FeNO in the observation group was significantly lower than that in the control group after treatment（P<0.05）. Conclusion Supplementation of vitamin D₃（800 IU/d） with glucocorticoid in the treatment of CVA can improve immune disorders, reduce airway inflammation, and thereby reduce airway hyperresponsiveness, and improve cough symptoms and prognosis in child patients.更多还原